Minimally Invasive Surgery Improves Short-term Outcomes in Elderly Colorectal Cancer Patients

Robinson, Christina M.; Balentine, Courtney J.; Marshall, C.; Wilks, Jonathan A.; Anaya, Daniel A.; Artinyan, Avo; Berger, David H.; Albo, Daniel

doi:10.1016/j.jss.2010.05.053

Cited by 31 publications

(13 citation statements)

References 34 publications

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“…In total, 29,663 patients were incorporated in the 8 studies, in which 1,410 patients were in the laparoscopic group and the remaining 28,253 patients were in the open surgery group. Two studies limited the patient age to ≥65 ( 10 , 13 ). Other studies limited the patient age to ≥70 ( 9 , 11 , 12 , 14 – 16 ).…”

Section: Resultsmentioning

confidence: 99%

“…Two studies showed the 5-year survival rate directly ( 10 , 14 ). Other studies showed the survival curve, by which the 5-year survival rate can be calculated ( 9 , 11 – 13 ). The I 2 value was 67.5%; thus, the random effects model was used to pool the 6 studies.…”

Section: Resultsmentioning

confidence: 99%

“…Third, only 8 studies were included in our meta-analysis; thus a larger cohort is required to confirm the results. Fourth, the age was limited to individuals aged ≥65 in 2 studies ( 10 , 13 ), ≥70 in 2 studies ( 9 , 16 ), ≥75 in 1 study ( 14 ), and ≥80 in 3 studies ( 11 , 12 , 15 ). Varying age may play an important role on reliability.…”

Section: Discussionmentioning

confidence: 99%

“…Fourth, the majority of the eligible studies did not show a 3- and 5-year survival rate directly, and this had to be estimated by survival curve, which may lead to errors. Finally, the difference of tumor location between eligible studies may also influence the reliability [colorectal cancer in 4 studies ( 11 – 13 , 15 ), colon cancer in 2 studies ( 10 , 14 ), and rectal cancer in 2 studies ( 9 , 16 )]. However, we performed funnel plot and Begg's test to evaluate the publication bias of the included studies and no obvious publication bias was found, which demonstrated our meta-analysis was reliable.…”

Section: Discussionmentioning

confidence: 99%

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Long-term outcomes of laparoscopy vs. open surgery for colorectal cancer in elderly patients: A meta-analysis

Wang

Zhao

et al. 2017

Molecular and Clinical Oncology

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The long-term outcome of laparoscopic surgery for geriatric patients with colorectal cancer remains unclear due to decreased functional reserves and increased medical comorbidities. A meta-analysis was performed in the present study to compare the long-term outcome between laparoscopy and laparotomy. Randomized controlled trials and comparative studies regarding laparoscopy vs. open surgery for colorectal cancer in elderly patients were searched in Pubmed, Embase, and Cochrane library between inception and April 20, 2017. The methodological quality of the cohort studies was evaluated using the Newcastle-Ottawa Scale. The meta-analysis was performed using Stata v12.0 software. Eight cohort studies were enrolled in the meta-analysis. Laparoscopic surgery was associated with a higher 3-year survival rate compared with open surgery [risk ratio (RR), 0.74; 95% confidence interval (CI), 0.61–0.90; P=0.003]. No significant difference was identified between laparoscopy and laparotomy regarding the 5-year survival rate (RR, 0.93; 95% CI, 0.78–1.11, P=0.424). The results of the meta-analysis indicated that the use of laparoscopic surgery on geriatric patients with colorectal cancer should be increased due to more improved long-term outcomes. All the studies included in the meta-analysis were case-control studies with selection bias and other confounding factors. Thus, larger sample sizes and multicenter randomized controlled trials are required to further validate the use of laparoscopic surgery as the preferred therapeutic option for elderly patients with colorectal cancer.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Long-term outcomes of laparoscopy vs. open surgery for colorectal cancer in elderly patients: A meta-analysis

Wang

Zhao

et al. 2017

Molecular and Clinical Oncology

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“…We agreed that laparoscopic surgery could meet the similar oncological quality as open surgery for CRC treatment through this study. The length of postoperative stay was shorter in the laparoscopic group, and several studies had confirmed the result [ 16 , 18 , 25 , 28 , 30 – 32 ]. The most evident benefit for elderly patients to receive laparoscopy surgery is the reduced hospital stay.…”

Section: Discussionmentioning

confidence: 62%

Advantage of laparoscopy surgery for elderly colorectal cancer patients without compromising oncologic outcome

et al. 2020

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Background Laparoscopic surgery has achieved significant results in elderly patients with colorectal cancer (CRC). In this study, we compared the short-term and long-term outcomes of open surgery and laparoscopic surgery in patients with CRC aged above 75 years at a single tertiary medical center. Methods We analyzed 967 patients who underwent curative resection for primary colorectal adenocarcinoma without distant metastasis between January 2009 and December 2015, in a single institution. Of the enrolled patients, 305 underwent laparoscopic surgery, and 662 received open laparotomy surgery. Results Compared to the patients who underwent open surgery, those who received laparoscopic surgery had significantly shorter postoperative stay (10.3 vs. 13.5 days p < 0.001) and similar postoperative morbidity (p = 0.354) and mortality (p = 0.082). In the laparoscopy cohort, six of 305 patients were converted to open surgery and one died. The long-term overall survival, cancer-specific survival, and recurrence rate were similar between both cohorts in each stage. Conclusions Laparoscopic surgery is suitable for elderly patients owing to shorter postoperative stay, similar long-term outcomes with open surgery, and acceptable low conversion rates. For long-term overall and oncological outcomes, the results of laparoscopic surgery were similar to that of open surgery in each TNM stage.

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Palliative Surgical Approaches for Older Patients with Colorectal Cancer

Zbar

Audisio

2013

Management of Colorectal Cancers in Older People

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Minimally Invasive Surgery Improves Short-term Outcomes in Elderly Colorectal Cancer Patients

Cited by 31 publications

References 34 publications

Long-term outcomes of laparoscopy vs. open surgery for colorectal cancer in elderly patients: A meta-analysis

Long-term outcomes of laparoscopy vs. open surgery for colorectal cancer in elderly patients: A meta-analysis

Advantage of laparoscopy surgery for elderly colorectal cancer patients without compromising oncologic outcome

Palliative Surgical Approaches for Older Patients with Colorectal Cancer

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